Provider Demographics
NPI:1447746995
Name:GOODPASTER, SONYA (LPC)
Entity type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:
Last Name:GOODPASTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 RUCKER BLVD
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-3625
Mailing Address - Country:US
Mailing Address - Phone:334-494-8039
Mailing Address - Fax:
Practice Address - Street 1:1405 RUCKER BLVD
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2236
Practice Address - Country:US
Practice Address - Phone:334-417-0212
Practice Address - Fax:334-417-0213
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4129101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health